Can True Gynecomastia (Glandular Tissues) Be Cured by Liposuction?

I have puffy nipples and I went to see a government plastic surgeon. After scanning she told me that the glandular tissue is about 2.5cm. She recommended that I skip the surgery as it is very mild. And if I really insist on doing it, it will be removed by liposuction and a "divider" to shave the tissues. No incision will be done. 1. Should I do the surgery? 2. Can liposuction really remove glandular tissues? 3. What is the size of the normal male breast tissue? 4. will there be scars?

Doctor Answers 30

Gynecomastia (male breast tissue) can be treated with liposuction and/or excision

Male breast development, or gynecomastia, can cause feelings of self-consciousness and embarrassment for some men. 

Gynecomastia can be treated by a number of methods, primarily liposuction and/or excision of excess breast tissue.

Gynecomastia is "graded" from Grade I (mild) to Grade III (significant breast development, including droop and excess skin).  The type of treatment is dictated by the extent of the condition and its severity.

To answer your specific questions: 

I have puffy nipples and I went to see a government plastic surgeon. After scanning she told me that the glandular tissue is about 2.5cm. She recommended that I skip the surgery as it is very mild. And if I really insist on doing it, it will be removed by liposuction and a "divider" to shave the tissues. No incision will be done. 1. Should I do the surgery?

The decision to have surgery or not is a very personal one.  This can only be answered by YOU, after you have done all your homework and researched the options, including experienced Board Certified Plastic Surgeons. 

2. Can liposuction really remove glandular tissues?

One type of liposuction is usually used for gynecomastia, as the tissue is more firm and fibrous than regular tissue.  The method is called ultrasonic-assisted liposuction, or UAL.  A common brand name machine is  called "VASER". 

Whether or not liposuction alone will remove all the tissue depends on your body.  I usually reserve the right to also make a small incision if needed, based on the results during surgery. 

3. What is the size of the normal male breast tissue?

The size of breast tissue in males varies significantly.  Factors associated with an increased amount of breast tissue include being overweight, having hormone imbalances, some medication or drug use, and puberty.  Rest assured that gynecomastia is quite common, and does not need to be treated if it is not of concern to you. 

4. will there be scars?

With ANY Plastic Surgical procedure, there are scars.  The location and degree of scarring will be minimized by "hiding" incisions in areas that are not visible in most situations.  Genetics plays the number one role in determining the quality of your scars.  Look to other areas of your body to see how your scars heal. 

San Francisco Plastic Surgeon
3.9 out of 5 stars 9 reviews


Typically fat is removed via liposuction and glandular tissue is removed via direct excision.To optimize the result both components need to be addressed.

About the Gynecomastia Surgical Techniques

Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you.

The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. 

Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Gynecomastia and Liposuction

Liposuction can be used to remove fat, but it is not effective in removing glandular tissue. I'm not sure what exactly she meant by a "divider" but there are some techniques that use an endoscopic shaver to remove the dense glandular tissue. The amount of glandular tissue in males varies widely, but if it is causing a distortion, one can consider surgical resection. In very mild cases, there may be little room for improvement and this would make the (small) risks of surgery outweigh the potential benefits.

As far as whether to do the surgery, that is a very personal decision you should make based on the risks and benefits presented to you by your surgeon. If you are unsure after your visit, you can consider seeking a second opinion.  With regards to scars, there are always small scars, even with just liposuction, but with gynecomastia in general, the scars are usually very small and inconspicuous.

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 39 reviews


The answer is sometimes yes, but maybe not.  In most patients with gynecomastia there are both glandular and fat components. Dense, firm glandular tissue does not respond well to liposuction alone, whereas fat can be treated nicely with liposuction.  If the glandular component is fairly small and the fatty component is larger, liposuction alone can make a worthwhile impact in selected cases.  In most patients, both components need to be addressed.  Typically this means partial resection of the glandular component combined with liposuction for the fatty component.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

Puffy Nipples Often Can Be Treated With Liposuction Alone

In my personal experience, many patients with “puffy nipples” can be treated solely with liposuction.  There are 2 reasons for this:
  1. Some patients with “puffy nipples”, have a purely fatty enlargement of their breasts, rather than a tough, rubbery glandular and fibrous tissue found in others.
  2. Others with “puffy nipples” can have primarily fatty enlargement, with only a minor component of firm, glandular tissue lying beneath

In the majority of these patients, I have had much success in using “Power-Assisted Liposuction” or PAL to completely treat their “puffy nipple” condition, resulting in a flat, normal appearing male chest.

In other more difficult cases, I have combined PAL with special “cutting” or “grating” liposuction cannulas, which literally chop up the firm breast tissue and remove it through suction. 

In a small subset of patients, the above techniques do not result in a completely flat chest.  In these patients, I perform a “stealth excision”, in which I make a several millimeter “stab” incision within the areolar skin, and then remove the stubborn breast tissue with a clamp and scissors.  A dissolvable stitch or two is used to close the tiny incision, leaving an imperceptible scar.

The normal male breast is usually not palpable, but “normal” is considered to be less than 2.5 cm in diameter by most physicians.
I hope that this answers your questions adequately.  Good luck!

Gynecomastia Surgery with Liposuction Alone

Hi ihategyne,

Thanks for the post. The short answer is no. Patients with true gynecomastia typically do not get ideal results with just liposuction. In true gynecomastia there is an excess of breast tissue which is not similar in consistency and texture to fatty tissue. Whereas liposuction is useful in removing fatty tissue, it is rarely successful in removing breast tissue.

I would recommend being evaluated by a plastic surgeon who specializes in gynecomastia surgery. There is no normal size of male breast tissue as each person is different. Also, there will be scars but in experienced hands these incision tend to heal very well.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 39 reviews

Glandular tissue

It is important to understand liposuction removes fat and surgery removes glandular tissue (which is firm, more dense).  Gynecomastia can be observed if it isn't bothersome.  It's a cosmetic procedure.  Anytime there is surgery there will be scars.  The scars are generally well hidden or camouflaged around the areola. 
This is the trade-off.  So in very mild cases, it may make more sense to wait.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Can True Gynecomastia (Glandular Tissues) Be Cured by Liposuction?

Liposuction is an effective technique to treat gynecomastia.  It there is significant skin excess, additional skin excisions techniques may be needed. 

John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon

John Nguyen, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 71 reviews

When Gynecomastia is Caused by Growth of Glandular Breast Tissue, Surgical Excision is Usually Necessary to Correct the Problem

                  When gynecomastia is caused by growth of glandular breast tissue surgical excision is usually necessary to correct the problem. In contrast, when breast growth occurs because of fat deposition, liposuction is the treatment of choice.

                  Glandular tissue tends to be thicker and more fibrous than fatty tissue. When breast tissue is present it can be very difficult to pass a liposuction canula through the tissue. For this reason, liposuction is rarely effective when glandular tissue is present.

                  Glandular tissue usually requires surgical excision. This can be performed through a periareolar incision with minimal scarring. Consultation with a board certified plastic surgeon should help determine what specific option is best for you.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.